Acessibilidade / Reportar erro

Cognitive Abilities Screening: Instrument-Short Form, Mini-Mental State Examination and Functional Activities Questionnaire in the illiterate elderly

Triagem de habilidades cognitivas em idosos analfabetos: Casi-S, mini-exame do estado mental e questionário de atividades funcionais

ABSTRACT

Dementia prevalence is increasing in developing countries due to population aging. Brief tests for assessing cognition and activities of daily living are very useful for the diagnosis of dementia by the clinician. Low education, particularly illiteracy, is a hindrance to the diagnosis of dementia in several regions of the world.

Objectives:

To compare the Brazilian version of the Cognitive Abilities Screening Instrument-Short Form (CASI-S) with the Mini-Mental State Examination (MMSE) and Pfeffer Functional Activities Questionnaire (PFAQ) for the diagnosis of dementia in illiterate elderly.

Methods:

A cross-sectional study with illiterate elderly of both genders seen at the outpatient clinics of the Institute of Gerontology and Geriatrics Jundiaí, São Paulo state was performed. Spearman's correlation coefficient was used to correlate CASI-S, MMSE and PFAQ scores.

Results:

The sample comprised 29 elderly over 57 years old whose mean scores on the CASI-S (scores ranging from 3 to 23) and the MMSE (scores ranging from 2 to 23) were 11.69 and 12.83, respectively. There was a strong significant correlation between the CASI-S and MMSE (r=0.75, p<0.001) and a moderate correlation coefficient that was significant and negative between the PFAQ and CASI-S (r= -0.53 p=0.003),similar to that between the MMSE and PFAQ (r= -0.41 p=0.025).

Conclusion:

The Brazilian version of the CASI-S demonstrates ease of application and correction in the illiterate elderly, and warrants further studies regarding its applicability for the diagnosis of dementia in populations with a heterogeneous educational background.

Key words:
CASI-S; MMSE; PFAQ; aging; cognition.

RESUMO

A prevalência de demência está aumentando nos países em desenvolvimento, devido ao envelhecimento da população. Testes breves para a avaliação da cognição e atividades de vida diária são muito úteis para o diagnóstico de demência pelo médico. Baixa escolaridade, especialmente analfabetismo, é um obstáculo para o diagnóstico de demência em diversas regiões do mundo.

Objetivos:

Comparar a versão brasileira do teste Casi-S com o Mini Exame do Estado Mental (MMSE) e Questionário de Atividades Funcionais de Pfeffer (QAFP) para o diagnóstico de demência de analfabetos idosos.

Métodos:

Estudo de corte transversal, com idosos de ambos os sexos, analfabetos, atendidos no Instituto de Geriatria e Gerontologia do município de Jundiaí, São Paulo. Foi utilizado o coeficiente de correlação de Spearman.

Resultados:

A amostra foi composta por 29 idosos analfabetos, com médias de escore no Casi-S e no MEEM de 11,69 (variando de 3 a 23 pontos) e 12,83 (variando entre 2 a 23 pontos), respectivamente. Observou-se uma correlação forte e significativa entre o Casi-S e o MEEM (r=0,75; p<0,001) e um coeficiente de correlação moderado, significativo e negativo entre o Casi-S e o QAFP (r= -0,53; p=0,003), o que foi semelhante ao observado entre o MEEM e o QAFP (r= -0.41 p=0.025). Nota-se, portanto, uma correlação importante entre o MEEM e o Casi-S e valores moderados e significativos entre o desempenho cognitivo e o comprometimento nas atividades de vida diária.

Conclusão:

Observa-se que o Casi-S é um teste de fácil aplicação e correção, e que merece mais estudos sobre sua aplicabilidade no diagnóstico de demência em populações com heterogeneidade educacional.

Palavras-chave:
Casi-S; MEEM; QAFP; envelhecimento; cognição.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

REFERENCES

  • 1
    Quinn A. Health, aging and cities. J Urban Health 2008;85:151-153.
  • 2
    Carvalho JAM, Garcia RA. The aging process in the Brazilian population: a demographic approach. Cad Saude Publica. 2003;19:725-733.
  • 3
    Fichman HC, Caramelli P, Sameshima K, Nitrini R. Decline of cognitive capacity during aging. Rev Bras Psiquiatr 2005;27:79-82.
  • 4
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC; 1994.
  • 5
    Caramelli P. Anatomo-clinical correlation in primary dementia. XVIII Brazilian Congress of Neurology Pre-Congress, 2, Course 21: 17-27. Sao Paulo: Brazilian Academy of Neurology; 1998.
  • 6
    Caramelli P, Silveira AS, Nitrini R. Epidemiologic survey of dementia in a community-dwelling Brazilian population. Alzheimer Dis Assoc Disord 2002;16:103-118.
  • 7
    Boller F, Duyckaerts C. Alzheimer's disease: clinical and anatomic aspects. In: T Feinberg and Farah M (editors). Behavioral Neurology and Neuropsychology. McGraw-Hill, New York;1997:521-544.
  • 8
    Damasceno A, Delicio AM, Mazo DFC, et al. Validation of the Brazilian Version of mini-test CASI-S. Arq Neuropsychiatr 2005;63:416-421.
  • 9
    Folstein MF, Folstein SE, Mchugh PR. Mini-Mental State: a practical method for grading the cognitive state of pacientes for the clinician. J Psychiatr Res 1975;12:189-198.
  • 10
    Roth M, Tym E, Mountjoy CQ, et al. CAMDEX. The Standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986; 149:698-709.
  • 11
    Teng EL, Larson EB, Lin KN, Graves AB, Liu HC. Screening for dementia: the Cognitive Abilities Screening Instrument - Short Version (CASI Short). Paper presented at the Annual Convention of the American Psychological Association,San Francisco; 1998.
  • 12
    Jorm AF, Masaki KH, Petrovitch H, Ross GW, White LR. Cognitive Deficits 3 to 6 Years Before Dementia Onset in a Population Sample: The Honolulu-Asia Aging Study. J Am Geriatr Soc 2005;53:452-455.
  • 13
    Huang CW, Chang WN, Huang SH, et al. Impact of homocysteine on cortical perfusion and cognitive decline in mild Alzheimer's dementia. Eur J Neurol 2013;20:1191-1197.
  • 14
    Lotfipour S, Cisneros V, Anderson CL, et al. Assessment of alcohol use patterns among spanish-speaking patients. Subst Abus 2013;34:155-161.
  • 15
    Lin KN, Wang PN, Liu HC, Teng EL. Cognitive abilities screening instrument, Chinese version 2.0 (CASI C-2.0): administration and clinical application. Acta Neurol Taiwan 2012;21:180-189.
  • 16
    Gatto NM, Varma R, Torres M, et al. Retinal microvascular abnormalities and cognitive function in Latino adults in Los Angeles. Ophthalmic Epidemiol 2012;19:127-136.
  • 17
    Damasceno A, Delicio AM, Mazo DF, et al. Primitive reflexes and cognitive function. Arq Neuropsiquiatr 2005;63:577-582.
  • 18
    Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiat Res 1983;17:37-49.
  • 19
    Pfeffer RI, Kurosaki TT, Harrah CH, et al. Measurement of Functional Activities in older adults in the community. J Gerontol 1982;37:323-329.
  • 20
    McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 2011;7: 263-269.
  • 21
    Brucki SMD, Nitrini R, Caramelli P. Bertolucci PHF, Okamoto IH. Tips for Using the Mini-Mental State Examination in Brazil. Arg Neuropsiquiatr 2003;61:777-781.
  • 22
    Laks J, Baptista EM, Contino AL, de Paula EO, Engelhardt E. Mini-Mental State Examination norms in a community-dwelling sample of elderly with low schooling in Brazil. Cad Saude Publica 2007;23:315- 319.
  • 23
    Bertolucci PH, Brucki SM, Campacci SR, Julian Y. The mini-mental state examination in a general population: impact of schooling. Arq Neuropsiquiatr 1994;52:1-7.
  • 24
    Almeida OP. Mini Mental State Examination and Diagnosis of Dementia in Brazil. Arg Neuropsiquiatr 1998;56:605-612.
  • 25
    Damin AE. Aplicação do questionário de mudança cognitive como método para rastreio de demências. Tese apresentada à FMUSP. 2011
  • 26
    Nitrini R, Caramelli P, et al. Diagnosis of Alzheimer's Disease in Brazil; cognitive and functional assessment. Arg Neuropsiquiatr 2005;63: 720-727.
  • 27
    Aprahamian I, Martinelli JE, Rasslan Z, Yassuda MS. Cognitive Screening in Elderly for Clinical. Clin Med Rev Bras 2008;6:254-259.

Publication Dates

  • Publication in this collection
    Dec 2013

History

  • Received
    02 Apr 2013
  • Accepted
    03 Oct 2013
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br